Post-Mortem Cardiac Magnetic Resonance in Explanted Heart of Patients with Sudden Death

Giovanni Donato Aquaro, Benedetta Guidi, Michele Emdin, Angela Pucci, Enrica Chiti, Alessandro Santurro, Matteo Scopetti, Federico Biondi, Aniello Maiese, Emanuela Turillazzi, Giovanni Camastra, Lorenzo Faggioni, Dania Cioni, Vittorio Fineschi, Emanuele Neri and Marco Di Paolo
Additional contact information
Giovanni Donato Aquaro: Academic Radiology, University of Pisa, 56126 Pisa, Italy
Benedetta Guidi: ASL Toscana Nord-Ovest, 55100 Lucca, Italy
Michele Emdin: Fondazione Toscana G. Monasterio, 56124 Pisa, Italy
Angela Pucci: Department of Surgical, Clinical and Molecular Pathology and of Critical Area, University of Pisa, 56126 Pisa, Italy
Enrica Chiti: Department of Surgical, Clinical and Molecular Pathology and of Critical Area, University of Pisa, 56126 Pisa, Italy
Alessandro Santurro: Department of Medicine, Surgery and Dentistry-Scuola Medica Salernitana, University of Salerno, 84084 Fisciano, Italy
Matteo Scopetti: Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, 00189 Rome, Italy
Federico Biondi: Cardiology Department, University of Trieste, 34127 Trieste, Italy
Aniello Maiese: UO Medicina Legale, University of Pisa, 56126 Pisa, Italy
Emanuela Turillazzi: UO Medicina Legale, University of Pisa, 56126 Pisa, Italy
Giovanni Camastra: Cardiac Department, Vannini Hospital Rome, 00177 Roma, Italy
Lorenzo Faggioni: Academic Radiology, University of Pisa, 56126 Pisa, Italy
Dania Cioni: Academic Radiology, University of Pisa, 56126 Pisa, Italy
Vittorio Fineschi: Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, 00185 Rome, Italy
Emanuele Neri: Academic Radiology, University of Pisa, 56126 Pisa, Italy
Marco Di Paolo: UO Medicina Legale, University of Pisa, 56126 Pisa, Italy

IJERPH, 2022, vol. 19, issue 20, 1-15

Abstract: Background: We sought to evaluate the diagnostic accuracy of post-mortem cardiac magnetic resonance (PMCMR) of explanted hearts to detect the cardiac causes of sudden death. Methods: PMCMR was performed in formalin-fixed explanted hearts of 115 cases of sudden death. Histological sampling of myocardium was performed using two different approaches: (1) guideline-based sampling; (2) guideline-based plus PMCMR-driven sampling. Results: Forensic diagnosis of cardiac cause of death was ascertained in 72 (63%) patients. When the guideline-driven histological sampling was used, the PMCMR interpretation matched with final forensic diagnosis in 93 out of 115 cases (81%) with sensitivity of 88% (79–95%), specificity of 65% (47–80%), PPV of 84% (78–90%), NPV of 73% (58–84%), accuracy of 81% (72–88%), and AUC of 0.77 (0.68–0.84). When a PMCMR-driven approach was added to the guideline-based one, the matching increased to 102 (89%) cases with a PMCMR sensitivity of 89% (80–94%), a specificity of 86% (67–96%), PPV of 95% (89–98%), NPV of 73% (59–83%), accuracy of 89% (81–93%), and AUC of 0.88 (0.80–0.93). Conclusions: PMCMR has high accuracy to identify the cardiac cause of sudden death and may be considered a valid auxilium for forensic diagnosis. PMCMR could improve histological diagnosis in conditions with focal myocardial involvement or demonstrating signs of myocardial ischemia.

Keywords: post-mortem cardiac magnetic resonance; sudden death; sudden cardiac death; autopsy; forensic investigation; histology (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View complete reference list from CitEc
Citations:

Downloads: (external link)
https://www.mdpi.com/1660-4601/19/20/13395/pdf (application/pdf)
https://www.mdpi.com/1660-4601/19/20/13395/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:19:y:2022:i:20:p:13395-:d:944861

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().